scholarly journals Effect of Peer Mentoring on Quality of Life among CKD Patients: Randomized Controlled Trial

2021 ◽  
pp. 1-11
Author(s):  
Nasrollah Ghahramani ◽  
Vernon M. Chinchilli ◽  
Jennifer L. Kraschnewski ◽  
Eugene J. Lengerich ◽  
Christopher N. Sciamanna

<b><i>Introduction:</i></b> CKD is associated with decreased quality of life (QOL). Peer mentoring (PM) leads to improved QOL in various chronic diseases. The effectiveness of PM on QOL of patients with CKD has not been previously studied. We conducted a randomized clinical trial to test the effectiveness of face-to-face (FTF) and online mentoring by trained peers, compared with usual care, on CKD patients’ QOL. <b><i>Methods:</i></b> We randomized 155 patients in one of 3 groups: (1) FTF PM (<i>n</i> = 52), (2) online PM (<i>n</i> = 52), and (3) textbook only (<i>n</i> = 51). Peer mentors were patients with CKD, who received formal training through 16 h of instruction. Participants in all 3 groups received a copy of an informational textbook about CKD. Participants assigned to PM received either 6 months of FTF or online PM. The outcomes included time-related changes in domain scores of the Kidney Disease Quality of Life (KDQOL)-36 for each of the groups over the 18-month study period. <b><i>Results:</i></b> Compared with baseline, online PM led to improved scores in domains of the KDQOL-36 at 18 months: Effects of Kidney Disease (<i>p</i> = 0.01), Burden of Kidney Disease (<i>p</i> = 0.01), Symptoms and Problems of Kidney Disease (<i>p</i> = 0.006), SF-12 Physical Composite Summary (<i>p</i> = 0.001), and SF-12 Mental Composite Summary (<i>p</i> &#x3c; 0.001). There were no statistically significant changes from baseline in domain scores of KDQOL-36 within the FTF PM and textbook-only groups. <b><i>Conclusions:</i></b> Among patients with CKD, online PM led to increased scores in domains of the KDQOL-36 at 18 months. The study was limited to English-speaking subjects with computer literacy and internet access.

2021 ◽  
Vol 4 (3) ◽  
pp. 60
Author(s):  
Gero von Gersdorff ◽  
Pia von Korn ◽  
André Duvinage ◽  
Gabriele Ihorst ◽  
Anika Josef ◽  
...  

Patients with chronic kidney disease (CKD) on hemodialysis (HD) experience treatment-related immobility and physical deconditioning, which is responsible for an increased risk of frailty and a high burden of multi-morbidity. Exercise has been shown to counteract this vicious cycle; however, its effectiveness has only been investigated in small cohorts. Therefore, the objective of the Dialysis Training Therapy (DiaTT) trial will be to assess the effects of a 12-month intradialytic exercise program on physical functioning, frailty and health economics in a large cohort of HD patients in a real-world setting. DiaTT will be a prospective, cluster-randomized (1:1), controlled, multi-center, interventional clinical trial across 28 dialysis units, aiming at the recruitment of >1100 CKD patients on HD. The intervention group will receive 12 months’ intradialytic exercise (combined aerobic and resistance training), whereas the usual care group will not receive intervention. The primary endpoint will be a change on the sit-to-stand test (STS60) result between baseline and 12 months. Secondary endpoints will include physical functioning, frailty, quality of life, 3-point MACE, hospitalizations, survival, quality of HD, health literacy and health care costs. By including almost as many patients as previously investigated in smaller trials, DiaTT will be the largest randomized, controlled trial assessing frailty, quality of life and mortality in the field of nephrology.


2021 ◽  
Author(s):  
Mohammad Habibur Rahman Sarker ◽  
Michiko Moriyama ◽  
Harun Ur Rashid ◽  
Md Moshiur Rahman ◽  
Mohammod Jobayer Chisti ◽  
...  

BACKGROUND Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. OBJECTIVE The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. METHODS A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. RESULTS Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. CONCLUSIONS It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30191


10.2196/30191 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e30191
Author(s):  
Mohammad Habibur Rahman Sarker ◽  
Michiko Moriyama ◽  
Harun Ur Rashid ◽  
Md Moshiur Rahman ◽  
Mohammod Jobayer Chisti ◽  
...  

Background Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. Objective The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. Methods A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. Results Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. Conclusions It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. Trial Registration ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 International Registered Report Identifier (IRRID) DERR1-10.2196/30191


2020 ◽  
Author(s):  
Hak Jin Kim ◽  
Hong Man Yoon ◽  
Keun Won Ryu ◽  
Young-Woo Kim ◽  
So Young Kim ◽  
...  

BACKGROUND After gastrectomy, patients may experience the postgastrectomy syndrome and face difficulties adapting to everyday diet. Recently, human health coaching via a mobile application (app) has been used for obese patients or patients with chronic diseases, with significant improvements in clinical outcomes. OBJECTIVE The aim of this study is to evaluate and compare the effects of human health coaching via a mobile app and conventional face-to-face counseling in patients who underwent gastrectomy for gastric cancers. METHODS This study is a single-institution, prospective randomized controlled trial comparing the mobile health and face-to-face counselling groups. After randomization, participants assigned to the mobile health coaching group will receive health coaching via a mobile app for 3 months after discharge, and the assigned coaches will provide personalized advice based on the self-recorded health data. Participants in the face-to-face group will have 1- and 3-months postoperative dietary consultations with a clinical dietitian. The primary endpoint is the food restriction score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-STO22, and secondary endpoints included all other quality of life scale scores and nutritional parameters. The calculated sample size is 180, and the outcomes will be measured until 1-year post-surgery. RESULTS Recruitment started in May, 2020 and currently 51 patients have enrolled in the study. Anticipated date for the completion of enrolment is December 31, 2021 and entire data collection is expected to be completed by December 2022. CONCLUSIONS This study will show the efficacy of human health coaching via a mobile app on dietary adaptation in patients who underwent gastrectomy. A relational approach based on personal data and timely intervention using a mobile platform could reduce patients’ trial and error and improve QoL. CLINICALTRIAL ClinicalTrials.gov, NCT04394585; http://clinicaltrials.gov/ct2/show/NCT040394585


10.2196/26814 ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. e26814
Author(s):  
J Carola Pérez ◽  
Olga Fernández ◽  
Cristián Cáceres ◽  
Álvaro E Carrasco ◽  
Markus Moessner ◽  
...  

Background Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear. Objective The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression. Methods A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467


2018 ◽  
Vol 31 (07) ◽  
pp. 1015-1025 ◽  
Author(s):  
Viviana M. Wuthrich ◽  
Ronald M. Rapee ◽  
Brian Draper ◽  
Henry Brodaty ◽  
Lee-Fay Low ◽  
...  

ABSTRACTObjectives:Modifiable factors associated with increased risk of cognitive decline include emotional (anxiety, depression), cognitive (low social and mental stimulation), and health factors (smoking, alcohol use, sedentary lifestyle, obesity). Older adults with anxiety and depression may be at heightened risk due to direct and indirect impacts of emotional distress on cognitive decline.Design:Randomized controlled trialSetting:Community sample attending a university clinic. Participants: 27 participants (female = 20) aged over 65 years (M = 72.56, SD = 6.74) with an anxiety and/or mood disorder. Interventions: two cognitive behavioral therapy (CBT) interventions (face-to-face or low intensity) that targeted emotional, health, and cognitive risks for cognitive decline.Measurements:Participants completed diagnostic interviews; self-report measures of anxiety, depression, quality of life, and lifestyle factors at baseline; post-treatment; and 3-month follow-up.Results:Both interventions resulted in significant and sustained improvements in depression, anxiety, quality of life, and physical and social activity. At post-treatment, face-to-face CBT demonstrated significantly greater improvements in emotional symptoms, alcohol use, and memory (exercise approached significance). At 3-month follow-up, gains were maintained and there were significantly greater increases in mental activity for face-to-face CBT, with social activity approaching significance. Conclusions: This study demonstrates the feasibility of CBT interventions to reduce emotional as well as lifestyle risk factors associated with cognitive decline in at-risk older participants. Large studies are needed to evaluate the long-term impact on cognitive decline. The trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial Registration No. ACTRN12618000939291).


2020 ◽  
pp. 019394592094248
Author(s):  
Hsiu-Lan Teng ◽  
Miaofen Yen ◽  
Susan Fetzer ◽  
Junne-Ming Sung ◽  
Shih-Yuan Hung

Research on dietary and lifestyle modifications to decrease cardiovascular risk and slow disease progression has been limited to patients in the later stages of chronic kidney disease (CKD). Studies on the effectiveness of stage-of-change-tailored interventions on lifestyle modifications for individuals with early stage CKD are limited. Using random assignment, 60 patients with early stage CKD who received up to six tailored intervention visits over 30 months were compared to 60 usual care patients on physical indicators, lifestyle behaviors, and quality of life. Tailored interventions were consistent with the trans-theoretical Model of Change. Waist circumference, nutrition, and stress management improved over time in the intervention group. There was no difference or change in quality of life. To promote a healthier lifestyle, findings suggest that clinicians working with patients with CKD should consider patients’ readiness to change their behaviors as well as implementation strategies tailored for different processes of change.


Author(s):  
A. M. Pisarenka

Surgery of patients with secondary hyperparathyroidism in the era of calcimimetics continues to play an important role in selected patients and achieves an efficient control of hyperparathyroidism. Taken together, the results of literature review suggest a clinically significant beneficial effect of surgical parathyroidectomy to decrease the overall and cardiovascular mortality in patients with secondary hyperparathyroidism due to chronic kidney disease. However, the independent randomized controlled trial comparing surgery with medical therapy to clarify the outcome and to improve the quality of life is in need.


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